Page 91 - Revista Portuguesa - SPORL - Vol 60. Nº3
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Figure 1
Leucoplakia’s Histology
presented a SCC; 68 (41,7%) had a premalignant carcinoma was the histology on the first biopsy
lesion and 45 (27,6%) had a benign lesion (p=0,017), where higher grades of dysplasia
as represented in Figure 1. For the analysis were associated with higher progression rates.
of possible risk factors for progression to On the other hand, age, gender, tobacco or
carcinoma, patients with malignant disease alcohol consumption, smoking cessation or
were excluded and only the 113 patients with the presence of GERD weren’t associated with
benign or pre-malignant histology were the progression to carcinoma. Furthermore,
analysed. when only premalignant lesions are taken
Mean age was 58,67 ± 12,532 years and 93 (82,3%) into consideration (n=68), the initial grade of
patients were male. Leucoplakia was localised dysplasia was still the only factor associated
on the left vocal fold in 37 (32,7%) patients, with the progression to SCC (p=0,004).
on the right vocal fold in 42 (37,2%) and was
bilateral in 34 (30,1%). Furthermore, 84 (74,3%) Discussion
patients smoked, where 33 (29,2%) claimed to Vocal fold leucoplakia can have a benign,
have stopped smoking after the diagnosis, 17 premalignant or malignant histology with
(15%) reported alcohol consumption, 16 (14,4%) reports of up to 50% of the lesions being non-
had a clinically diagnosed GERD and 6 (5,3%) benign in the literature . This study included
4
reported vocal abuse. Median follow-up was 24 163 patients submitted to MLS due to vocal fold
(8 - 43,5) months. During this period 39 patients leucoplakia in a tertiary hospital centre where
had a new lesion and were submitted to an 31% of the lesions were malignant and 43%
additional MLS, where 25 (22,1%) performed a were pre-malignant. These results are higher
total of 2 surgeries, 8 (7,1%) performed 3 and 6 than what has been reported previously . Thus,
4
(5,3%) were submitted to 4 MLS. patients with leucoplakia should be followed
During follow-up 15 (13,3%) patients progressed carefully and a biopsy should be performed
to SCC. Comparison of different characteristics since the percentage of malignant and pre-
between patients that progressed to SCC and malignant lesions could be higher than what
patients that didn’t progress are listed on Table was previously thought.
1. The only factor associated with progression to It has been established that vocal fold
Volume 60 . Nº3 . Setembro 2022 247
